Copyright ©The Author(s) 2019.
World J Clin Cases. Jan 6, 2019; 7(1): 1-9
Published online Jan 6, 2019. doi: 10.12998/wjcc.v7.i1.1
Table 1 Risk factors for the development of dysplasia in inflammatory bowel disease
Risk factorsEndoscopic factors
Disease durationActive disease
Disease extentPresence of strictures in ulcerative colitis
Disease severityPost inflammatory polyps
Past dysplasiaTubular appearance of colon with loss of colonic haustration
Primary sclerosing cholangitis
Family history of colorectal cancer
Table 2 Commonly used guidelines for the screening of neoplasia in inflammatory bowel disease
SocietyCommencementRisk stratificationInterval
ECCO, 20178 yr post symptom onsetStricture or dysplasia, PSC, extensive colitis, severe active inflammationAnnual
Mild to moderate active inflammation, post inflammatory polyps, or first degree relative with CRC2-3 yr
None of the above features5 yr
AGA, 20108 yr post diagnosisActive inflammation, stricture, post inflammatory polyps, history of dysplasia, first degree relative with CRC, PSCAnnual
After 2 negative colonoscopies1-3 yr
ACG, 20108-10 yr post diagnosisNo risk stratification1-2 yr
BSG, 201010 yr post symptom onsetModerate/severe active inflammation on the prior colonoscopy, stricture, dysplasia, PSC, first degree relative with CRC aged < 50 yrAnnual
Mild active inflammation on prior colonoscopy, post inflammatory polyps, first degree relative with CRC aged > 50 yr3 yr
Nil prior inflammation, left sided colitis or CD colitis affecting > 50% surface area of the colon5 yr
Table 3 Low, intermediate, and high risk features to risk stratify patients and guide surveillance intervals
Low riskIntermediate riskHigh risk
Quiescent disease, even with extensive colonic involvement; left sided IBDExtensive colonic involvement with mild inflammation; post inflammatory polyps; CRC in 1st degree relative aged > 50Extensive colitis with moderate/severe inflammation; primary sclerosing cholangitis; colonic strictures1; dysplasia of any grade1; CRC in 1st degree relative aged < 50
Table 4 SCENIC consensus nomenclature of dysplasia in inflammatory bowel disease
Visible dysplasiaDysplasia confirmed histologically on a targeted biopsy
Invisible dysplasiaDysplasia on a random biopsy
PolypoidLesion protruding ≥ 2.5 mm into the lumen
Non polypoidLesion protruding < 2.5 mm into the lumen or not protruding
Superficial elevatedProtrusion < 2.5 mm
PedunculatedAttached to mucosa via stalk
SessileNot attacked via stalk; base contiguous with mucosa
FlatNo protrusion above mucosa
DepressedAt least a portion of lesion depressed below mucosa
UlceratedFibrinous appearing base within lesion
Distinct borderEasily identified from surrounding mucosa
Indistinct borderNot discrete; difficult to distinguish from surrounding mucosa